A mental health surge for the other pandemic

While images of overcrowded hospitals and lines of people waiting for the vaccine have dominated news on COVID-19, another major issue has unfortunately been hidden: the impact of the pandemic on Americans’ mental health. It has strained people throughout the country in unforeseen ways. A New York state physical therapist had recurring visions of her children being murdered after she contracted the virus. One of every five COVID-19 patients develops a mental health problem. The impact of this other pandemic — the mental toll from COVID-19 — on health care providers, caregivers, and families across the nation cries out for a surge in mental health care.

While vaccinations will protect our physical health, the mental health impact will be with us long after COVID-19 is under control. Millions upon millions have all seen or experienced the fears from uncertainty, the stress of isolation, loneliness, managing children at home, and the loss of a job or income. Over half of all Americans report that their mental health has suffered from stress, producing sleep loss, over eating, and more alcohol consumption. Depression has quadrupled. Diseases of despair like substance abuse have risen. Black and Hispanic Americans have seen even worse mental health problems.

The projected 567,000 deaths by April will have left millions grieving for the loss of a family member. An estimated 10 percent of COVID-19 patients, roughly 2 million Americans, have become long haulers who suffer debilitating symptoms including chest pain, shortness of breath, and mental deterioration. Health professionals and family caregivers are experiencing high levels of burn-out and isolation. Mental health problems are also worse for people with chronic health conditions.

The nation urgently needs a mental health campaign to stave off additional damage from this virus. Congress and the incoming Biden administration should take the following three key steps.

Universal public mental health messaging. While public health agencies and have developed a population-wide approach to mental and behavioral health, they have not yet deployed it during the pandemic. The public needs to hear messages that acknowledge stress and offer coping strategies. Everyone needs to understand that people under this much stress have adverse responses. The message should be that we are normal people responding to an abnormal situation. The responses we have, including disrupted sleep, general feelings of anxiety and worry, anger at the situation and restrictions and feeling helpless, are to be expected. The messaging should also include suggestions on coping, including keeping to the usual sleep and wake cycle, taking time to prepare healthier meals, getting some routine exercise, addressing our own fears and worries, and better managing our stress. It should help people in need to connect to services through existing channels like the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline and peer support programs. The messaging should be packaged in a variety of formats from television to online ads and free for any media outlet to use. It should be based on the science of public health messaging developed in conjunction with mental health experts and schools of public health.

Psychoeducational webinars. Some private efforts have focused on reaching Americans who are at higher risk who need intensive, brief services, both in groups and individually. Those efforts need a federal boost to become commonplace. They can include psychoeducational webinars delivered by therapists on specific topics such as managing kids and work from home, coping with separation from older family members, guilt over possibly infecting others are all possibilities. Professional societies representing all licensed mental health clinicians can stand up these programs and help promote them. Communities of color, rural communities, and other underserved groups will all need their own outreach strategies to ensure were reaching all Americans equitably.

Scaled-up trauma therapy. For those who have specific clinical needs, therapists need to be trained in effective responses to trauma, such as those developed by the National Child Traumatic Stress Network and the Veterans Administration Health Service on Psychological First Aid. SAMHSA should offer, through their existing extensive training networks professional education for all licensed mental health clinicians on how to address this type of trauma. It should include how to deliver effective group and individual virtual interventions. The federal government needs to offer training to all licensed counselors, social workers, psychologists, and psychiatrists, on how to deliver effective services, and assure reimbursement for services to meet the national need.

The cost of these initiatives will require a federal investment. Financing would activate SAMHSA’s public health outreach and training network. It would move the mental health community toward a unified vision for treating all the nation’s mental health needs comprehensively. Like a vaccine, this investment will produce dividends through a stronger, healthier nation and faster economic recovery. It is time for a mental health surge.

Douglas Tynan, Ph.D, is President-Elect of the Delaware Psychological Association and David Kendall is Senior Fellow for Health and Fiscal Policy at Third Way.